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When treating patients suspected of having malaria, it is essential that treatment does not commence until the diagnosis of malaria has been established. The obvious exception is in waiting for confirmation to treat suspected malaria if the patient shows signs of severe malaria, and clinical suspicion for malaria is high. This activity reviews the indications, contraindications, adverse events, and other key elements of antimalarial therapy in the clinical setting related to the essential points needed by members of an interprofessional team managing the care of patients with a malarial infection require treatment. Objectives: Identify the mechanism of action of various members of the antimalarial class. Outline the contraindications and toxicity of antimalarial drugs. Review the appropriate follow-up and monitoring of antimalarial agents. Explain the importance of antimalarial therapy and how it affects therapeutic strategy to improve care coordination and communication among the interprofessional team when using these agents to achieve therapeutic outcomes. Access free multiple choice questions on this topic.

Because of mass migration, malaria cases are now being diagnosed in the USA. Malaria can have a diverse presentation, and it is essential to be aware of this diagnosis when evaluating a patient with a fever or a traveler from the tropics. All interprofessional team members, including healthcare workers, including nurse practitioners, need to know the basic features of the antimalarial medications and parameters to monitor, as these drugs do have potent adverse effects. G6PD screening is recommended if the patient will start on chloroquine, hydroxychloroquine, and primaquine. If the patient has known mild to moderate G6PD deficiency or unknown status and is on any of these three medications, then it is recommended to obtain a baseline CBC as well as a CBC on day three and day 8 of therapy. A baseline ECG is recommended with primaquine, artemether-lumefantrine, mefloquine, quinine, and quinidine. Continuous telemetry monitoring for hypotension and cardiac conduction changes is recommended while patients are on IV quinidine. Also, periodic blood glucose monitoring to check for hypoglycemia should be performed while on IV therapy. A negative pregnancy test for women of childbearing age should be performed before starting primaquine. Nurses and pharmacists should assist the team in educating the patient and family regarding the safe use of these medications. Pharmacists also need to verify dosing and perform medication reconciliation, reporting any issues to the team. An infectious disease expert should always be consulted when dealing with a patient with malaria because of drug resistance and constant changes in the drugs recommended.[19][20] The interprofessional healthcare team approach can result in improved outcomes for malaria patients [Level 5]